- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $30.90 / $83.18
| Facility | | $10.00 | $30.90 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $14.13
| Professional | | $10.00 | $10.00 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $58.88
| Facility | | $14.13 | $14.13 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $10.72
| Professional | | $6.92 | $6.92 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $53.70 / $74.13
| Professional | | $31.62 | $53.70 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $32.36 / $64.57
| Facility | | $14.13 | $32.36 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $10.23 / $24.55
| Professional | | $7.59 | $10.23 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $16.98 / $20.89
| Professional | | $14.13 | $16.98 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $23.44 / $27.54
| Professional | | $8.71 | $23.44 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $15.14 / $16.60
| Facility | | $13.18 | $15.14 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $29.51 / $33.88
| Professional | | $16.60 | $29.51 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $20.42 / $10,000.00
| Facility | | $10.96 | $20.42 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $19.95 / $10,000.00
| Professional | | $10.96 | $19.95 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $14.13 / $23.99
| Facility | | $5.89 | $14.13 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $7.76 / $15.49
| Professional | | $5.89 | $7.76 | $15.49 |